Hana Fit Coach Personal Training Consultation Form

Hana Fit Coach

Personal Trainer
Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
What city/state do you live in?*
How did you come across this application?*
What is your current occupation?*
Date of Birth*

MonthDayYear
Age*
years
Height*
FT'INCHES
Weight*
LBS
70% of participants see progress when they write down their measurements. I would be happy to take these measurements at our first session (if that works best).

Video on how to take measurements: https://youtu.be/IA9zwUM_gaw
Chest Measurement
Inches
Waist Measurement
Inches
Hip Measurement
Inches
Thigh Measurement
Inches
Calf Measurement
Inches
Upper Arm Measurement
Inches
What is your goal with fitness?*

Weight lossMuscle gainImproved physical fitnessLifestyle changesBetter relationship with foodSports performanceOther
Why is this your goal? What are you looking to benefit from by reaching this goal?*
What have you tried in the past?*
What has been your biggest challenge around reaching this goal?*
Why is NOW the time to seek out coaching and accomplish these goals?*
What do you need the most support with in your journey? When do you feel stuck? *Choose as many as you would like**

WorkoutsMindsetPersonal DevelopmentOther
Have you tracked food before?*

YesNo
How active is your job?*

Lightly activeModerately activeVery ActiveSedentary
What does your current workout routine look like? Gym vs home workouts? Cardio? How many days a week? Please elaborate.*
How advanced would you consider yourself with strength training?*

Intermediate (1-3 years) - I have some experience and feel pretty comfortableBeginner (less than a year of lifting) - little to no experience with weight liftingAdvanced (4+ years) - I'm pretty well versed in the gym and feel comfortable
Do you have any injuries?*
How many days a week are you currently working out?*
Is anyone else making the decision to invest in coaching?*
On a scale of 0-5, please rate your readiness for change. 1-being "not ready" and 5 being "I'm ready to make this change now"*
1:1 coaching starts at a 3 figure investment monthly. Are you ready to start investing in yourself?*

HELL YES!I'm not ready to invest in myself at this time
How often are you willing to train a week to reach your goal?*
(1-7 days a week)
At what times during the day would you prefer to train?*

MorningMid-DayAfternoonEvening
How often do you want to do Personal Training a week? (We will discuss these options further, you aren't committed to this.)*
Please Choose
PT 60 Min Sessions Package Options (We will discuss these options further, you aren't committed to this.)*

6 hours12 hours18 hours24 hours30 min session optionsSession by session option
1.) CANCELLATIONS

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

2.) LATE ARRIVALS

Each session shall be 30 min+ in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.
Anything else I should know?
I AGREE TO THE ABOVE TERMS & CONDITIONS*

YesNo
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